Organization
ELLEN J MATHESON FUNCTIONAL WELLNESS SOLUTIONS, LLC
Active
Other names
eljema wellness
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN J MATHESON MS, CNS, LMT (CERTIFIED NUTRITION SPECIALIST)
(843) 410-8567
Entity
Organization
Contact information
Practice address
621 WAPPOO RD, SEED OF LIFE COLLECTIVE, CHARLESTON, SC 29407-1800
(843) 410-8567
Mailing address
2948 CATHEDRAL LN, CHARLESTON, SC 29414-7309
(843) 324-5736
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
174H00000X
Health Educator
—
—
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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